| NPI | 1548202799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: TX N1163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME93787) |
| 202K00000X (Licence: SC 20371) | |
| 207P00000X Emergency Medicine (Licence: SC 20371) | |
| 207R00000X Internal Medicine (Licence: CA 139302) | |
| 207P00000X Emergency Medicine (Licence: TX N1163) | |
| 207Q00000X Family Medicine (Licence: SC 20371) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-10-17 |